Disposable surgical tourniquet



April 7, 1970 Filed Dec.

W. A. BISHOP, JR

DI SPOSABLE SURGICAL TOURNIQUET 2 Sheets-Sheet 1 INVENTOR.

WILLIAM A. BISHOP, JR.

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ATTORNEYS A ril 7, 1970 BISHOP, JR 3,504,675

DISPOSABLE SURGICAL TOURNIQUET Filed Dec. 10, 1965 2 Sheets-Sheet 2 INVENTOR.

WILLIAM A. BISHOP, JR.

ATTORNEYS United States Patent 3,504,675 DISPOSABLE SURGICAL TOURNIQUET William A. Bishop, Jr., 2620 N. 3rd St., Phoenix, Ariz. 85004 Filed Dec. 10, 1965, Ser. No. 513,135 Int. Cl. A61b 17/12; A61f 13/00 U.S. Cl. 128-327 1 Claim ABSTRACT OF THE DISCLOSURE My invention relates to a unitary disposable tourniquet cuff and more in particular to an inexpensive sterile disposable tourniquet cuff package capable of long storage for use in conditions of emergency.

Surgical tourniquets for hospital use are of necessity relatively expensive instrumentalities and generally speaking cannot be made available for emergency use, such as to prevent loss of blood in case of an accident, the spreading of venum in case of a snake bite or the control of circulation generally in emergency conditions. Physicians and surgeons frequently carry a tourniquet which can be used for emergency situations, but many times physicians are not available when the emergency occurs. A common practice, therefore, is to loop a cord or narrow piece of cloth around a limb, insert a stick, rod or any handy instrument under the looped material, and then impart a twist to a part of the looped material to tighten it against the member in which circulation is to be reduced. This is at best a poor measure, although sometimes better than nothing, because there is no way in which the applicator of such an improvised tourniquet can determine the tightness with which he has applied it, and injury to a limb can readily occur merely from the use of such an improvisation. It is therefore desirable that a tournique cuff intended for emergency use be equipped with the principal advantageous features of a regular surgical tourniquet found in hospital operating rooms, that it be relatively very inexpensive so that it can be made readily available on a stand-by basis, that it have a relatively long useful storage life, and that it also preferably be sterile. Such disposable cuffs, while intended primarily for emergency use, may have other advantages as the description will bring out.

Accordingly, a principal object of my present invention is the provision of an improved unitary disposable tuorniquet particularly intended for emergency use, but also having other desirable uses.

Another object is the provision of a surgical tourniquet which may be stored for long periods of time and remain substantially in as good condition after long storage as when first produced.

Still another object of the invention is the provision of a surgical tourniquet with which any of the usual manometer devices, inflation devices and the like may be used readily, including, if necessary, an ordinary small hand pump.

A further object of the invention is the provision of a unitary disposable surgical tourniquet cuff which may be relatively quickly applied and which will remain in position without shifting of superposed convolutilons of the cuff even during emergency handling of a patient.

Other specific objects and features of the invention will be apparent from the following detailed description taken with the accompanying drawings wherein:

FIG. 1 is an elevational view showing a tourniquet produced in accordance with my present invention;

FIGS. 2 and 3 are transverse sectional views taken along the lines 2-2 and 33 of FIG. 1;

FIG. 4 is a transverse view similar to FIG. 2 but showing a modification;

FIG. 5 shows still another form of disposable cuff with a special stiffening member;

FIG. 6 is a transverse sectional view taken on the lines 6-6 of FIG. 5;

FIG. 7 shows a standard type of rolled tape which may be employed in accordance with my invention to secure the unitary disposable tourniquet cuff in position;

FIG. 8 shows one manner in which a first Step may be taken to utilize the tape of the type shown in FIG. 7;

FIG. 9 is a transverse sectional view taken on the line 99 of FIG. 8; and

FIG. 10 is a perspective view showing a unitary sterile package of which the unitary disposable tourniquet cuff of my invention forms a part.

According to the principal features of my invention, I provide a unitary, laminar assembly of plastic material forming a bladder for retaining air under suitable pressure to perform its tourniquet function. Sealed through the wall of the unitary body is a valve stem or the like communicating with the interior of the bladder for introducing suitable amounts of gas under pressure therein. When the cuff is to be used, it is convolutely wound around a body member in a conventional manner with double-sided, pressure-sensitive tape disposed between the convolutions to hold them in place, and air or other gas then introduced at suitable pressure into the hollow interior portion of the cuff forming the bladder. The pressure-sensitive tape may extend substantially entirely across the bottom surface of the cuff, except for that portion thereof which may engage against the skin, and the fact that the tape engages entirely across the cuff and seals the overlapping convolutions together assists in preventing relative side shifting of the convolutions.

Referring now first to FIGS. 1, 2 and 3, the surgical cuff, indicated generally by the reference character 11, includes one relatively thick, preferably inelastic layer 12 of suitable plastic, and a relatively thinner, slightly elastic plastic layer 13, the two layers being sealed together at their edges 14 and 16 to leave an open area 17 which can retain air under pressure and therefore acts as a conventional surgical cuff bladder .A suitable valve stem 18 extends through the side edge of the cuff and has its inside end in contact with the open or bladder area 17, the outer end adapted for attachment to a source of gas under pressure (not shown). As a rule, surgical cuffs have employed a relatively narrow and long end extension, sometimes called a strap, which has been used in various ways to hold the cuff in assembled relation around a body member of a patient. In the present case, in order to utilize a standard type of pressure-sensitive tape to its maximum extent, an extension is formed having the same width as the cuff itself to permit maximum variance in the selection and use of such double-sided adhesive tape as may be available. The extension is provided by merely fastening plastic sheets 12 and 13 together in face-to-face relation so that no air will enter between them at one end of the cuff, as shown in FIG. 3. It should be understood that this extension or strap may be of any desired width or length.

I have already pointed out that a stiffening member may be used as required, and I have found that this stiffening member may comprise the layer 12 of plastic which may be made of a somewhat more rigid material or be somewhat thicker than the layer 13, as FIG. 2 shows. I may, however, use any of the simple stiffening features shown in my copending application Ser. No. 450,612, filed Apr. 26, 1965. Illustratively, a separate stiffener 19 may be enclosed in a separate compartment made by folding a section of relatively thin sheet plastic 21 on itself, and continuing the folding of this plastic sheet to form a bladder compartment 22, all in such a way as to leave the outside surfaces, both at the back and in the front, of the cuff entirely unobstructed in the same way as the cuff shown in FIGS. 1, 2 and 3. It should also be borne in mind that the edges are sealed together as shown in FIG. 2 to form a separate bladder, and that as in FIG. 3, the layers may be brought together to form the extension, and at this point it is unnecessary that the special stiffener 19 be included.

A simple form of the invention which is inexpensive to produce and has shown many good functional characteristics is shown in FIGS. 5 and 6. A relatively rigid sheet of plastic is shaped to form a stiffener 23 which fits fairly snugly between top and bottom relatively thinner and slightly elastic top and bottom sheets 24 and 26 which are sealed at their edges to form a bladder, with the stiffener 23 within the bladder. A number of oval openings 27 are provided in the stiffener 23, and the sheets 24 and 26 are secured together at a center area 28, so that the top and bottom sheets may shift sufficiently with respect to each other as the cuff is convolutely wound on a body member. An extension or strap portion 29 is formed suitably by sealing the sheets 24 and 26 fully together. It may be slightly tapered and provided with a square end 31 approximately corresponding with the width of the adhesive tape to be used. The inner end 32 of the cuff is, of course, sealed, and while the stiffener should practically fill the bladder space transversely of the cuff, open space areas are provided at ends of the stifiener to facilitate equalization of pressure within the bladder. Moreover, a tube 36 sealed through one side edge of the cuff may terminate in an edge recess 37 in the stiffener 23, so that air or other gas as introduced will tend to spread to both sides of the stiffener. Moreover, there is some pressureequalizing action at the openings 27 and around the sealed center area 28.

While special separate sections of double-coated, pressure-sensitive tape may be prepared and utilized with the present invention and the special sections incorporated within the envelope package in which the cuff is housed, I prefer to use a commercially available double-sided, pressure-sensitive tape such as shown in a roll 43 in FIG. 7. Here the tape 44 is a commercial item and has pressure-sensitive adhesive on both sides thereof. The pressure-sensitive adhesive coated sides are protected by two layers 46 and 47 of thin fabric, or the like, which has been treated to be relatively easily removed without having the adhesive adhere thereto during such removal. When using such tape, a suitable length is cut off and one of the protective fabric layers such as 46 removed, and the tape placed over and caused to adhere against the disposable cuff as shown in FIG. 8. The tape layer 44 then adheres directly to the cuff, and a second layer of pressure-sensitive material is then made available by merely peeling off the protective layer 47 as indicated in FIG. 8. A condition will then result as shown in FIG. 9. While the width of the tape may vary, it may be just slightly narrower than the surgical cuff itself, as shown in FIG. 8, so that the convolutions of the cuff when applied to the arm of a patient will be secured together substantially across the entire width of the convolution. This arrangement seems to facilitate maintaining the convolutions flat, preventing them from bunching up transversely, so that an unusually firm stiffening member may not be required. Those skilled in the art will understand that in many surgical cuffs employed in hospitals, the stiffening member is of relatively thin metal which will roll up in a longitudinal direction, but which will hold firm or rigid in a transverse direction. It is also true of a plastic strip, that if it is bent in one direction, as in winding the cuff convolutely, that bending in an opposite direction becomes impossible. In the present invention, however, a rigid stiffening member approaching the strength and rigidity of such a metal stiffener is entirely unnecessary. Because of this fact, and other structural features, it is possible to produce the present cuff relatively inexpensively so that it can be furnished at relatively low cost and it becomes truly a disposable item.

The surgical sufi of the present invention is preferably made available to the medical profession in the form of a package such as shown in FIG. 10, in which there is an outer cover of thin transparent flexible plastic of generally tubular shape, with ends 51 (one end appearing in the drawing), an annular side wall 52, and a relatively long flap 53 which is adhesively secured to the side wall but which may be torn away simply to make the cuff available. The cuff is rolled up into a relatively small package of a size to fit snugly into the envelope. There are several available plastics which can be used for producing the envelope package which are substantially entirely free of pores and will retain a partial pressure for very long periods of time. These materials are highly transparent, and in layers as thin as one or two thousandths of an inch, very strong. The product sold as Mylar is one such product which may be used. The cuff is preferably introduced into the envelope in sterile condition and a small amount of a sterilizing and preserving chemical which will vaporize within the envelope may also be introduced to maintain the cuff in prime usable condition for a very long period of time, regardless of the conditions of storage. Sterilizing may be by usual means, such as autoclaving, by irradiation or by chemicals, and as a preservative and antioxidant to protect both the plastic and tape, many suitable chemicals are available.

The present invention is not concerned with the mannet in which air or other gas under pressure is introduced into the cuff during use, but I may use any of the inflatable means with quick connect and disconnect assembly such as shown in my co-pending application Ser. No. 431,087, filed Feb. 8, 1965, now abandoned.

While the surgical cuff of the present invention is intended to a great extent for use in case of accidents and may be supplied in adequate quantity in first-aid conveyances, first-aid stations, civil defense stations, and the like, the present cuff may also be employed for individual patients in hospitals. The present practice of using blood pressure apparatus with this fabric cuff and rubber bladder is not always satisfactory from several standpoints. The disposable cuff of the present invention is so inexpensive, that one can be furnished to an individual patient and it is only necessary for a nurse, technician or physician to utilize conventional hospital equipment, such as a manometer and pressure source, by attaching them to the disposable cuff inflating system.

I have described and shown a simple, inexpensive embodiment of the invention so that those skilled in the art may understand the manner of practicing the same, but the scope of the invention is defined by the claim.

I claim:

1. A disposable tourniquet cuff comprising:

(a) a pair of elongated sheets of relatively thin flexible and partially resilient plastic material sealed together at their edges to form a bladder, and

(b) a continuous stiffener of relatively less flexible, generally firm and inelastic plastic material generally filling said bladder but spaced at its ends from sealed edges forming the bladder,

(c) said stiffener having at least one means defining an opening positioned longitudinally of the cuff,

(d) said sheets of partially resilient material secured together at a midpoint within the area of said means defining an opening.

References Cited UNITED STATES PATENTS Jones 128--327 Baum et a1. 128--327 Hutchins 128171 X Towle et a1. 128155 Dritz 128-351 Schenker 128-2.05

DALTON L. TRULUCK, Primary Examiner Hanafin 128327 10 12 17 US. Cl. X.R. 

